From: Richard Merkin

From: Richard Merkin To: 'jeffrey E.' <jeevacation®gmail.com> Subject: Date: Thu, 16 Oct 2014 14:06:27 +0000 Hi, Sorry for the delay. I spoke to both UCLA and Keck school of medicine. Both, of course would love to see you, but I am sure that is not necessary[l could set up neurosurgical consults in Boston or Johns Hopkins just as well]. There is no extrusion and with bulging discs there certainly is the opportunity with therapy to control the symptoms. For disc issues with, if you can manage the pain, the results six months later do not show any advantage of surgery. For the stenosis that is a different issue. Unfortunately many surgeons[most] operate by the MRI and not by the signs and symptoms of the patient. Have you seen a neurologist? Have you gotten an EMG and a nerve conduction study? These tests will help decide if you would or should have surgery today or can delay as long as possible[maybe forever]. If you do decide to go to the next step and want me to, I will come and accompany you to your physician. Hope you're feeling better! EFTA00688364